The warm weather has finally arrived and we are showing off our sandals and ladies want to show off their new nail color. But here is the dilemma, your feet are not in the best shape since winter and they need a little attention. You want to whisk away the calluses on the soles of your feet so they can be smooth for their summer debut.

There is a new product that has recently gained a lot of popularity in the past few months and has been all over the media and television…the PedEgg™. This little gadget has become quite “the star” in temporarily removing calluses on the feet. But how safe is it? When using any foot care product, there are some precautions that one should take and questions that you should ask yourself before using. First, examine our feet to be sure that there are no conditions that may be exacerbated by rigorous callus removal. How thick are your calluses? Do you have a preexisting conditions that may cause unforeseen or unusual complications that may not be present in normal healthy patients? Should you seek advice from your doctor before using?

Although calluses are unsightly and can cause some distress, you still want to be careful before attempting any type of skin removal procedure, even minor ones. Diabetic patients need to be particularly cautious in using this product, especially if they are neuropathic or insensate, meaning they lack the ability to detect sensation, pressure, or pain, as an injury or shaving the callus too close may cause injury leading to more serious medical issues. While the PedEgg™ seems like a great device to use, injuries and cuts can occur if too much pressure is applied, even in healthy patients. If you are a diabetic, that could definitely potentially mean a trip to the emergency room or and extended hospital stay from the injury.

Calluses are areas of skin that thicken due to increased friction in the area. There are many causes of calluses, such as ill fitting shoes or socks, socks bunching up, or bony prominences on your feet. If your calluses are troublesome or painful, seek professional podiatric care for advice on how best to treat them. There many inexpensive, effective, less hazardous treatments that can be safely done at home and without the risk of injury that can provide some temporary relief.

Here are some helpful hints and easy home treatments that may be helpful lessening the formation of calluses:

1. File away any calluses with a pumice stone that may be forming after a shower, as your skin has softened and the skin is easier to remove.
2. Wear socks that have extra padding in the heel, ball and toe areas, as these areas are commonly where calluses occur.
3. Apply lotions or moisturizers generously to your feet daily, particularly after showering. Doing this increases the moisture in your skin to help prevent callus formation. Also applying Vaseline and socks after a bath or shower can help soften the skin on your feet.
4. Try not to wear high heeled shoes on a regular basis. High heels place the foot at an angled position causing the foot to push forward in the shoe box, causing callus formation on the ball of the foot due to the increased pressure.

Following these simple tips may improve the overall appearance of your feet. Remember, not every foot care product is not appropriate for use by every patient. There are many determining factors in deciding if an over the counter product is safe to use. Be an advocate for your foot health.

For some people out there checking winter boots for creepy critters is a habbit that can’t be broken. Generally though, people will just slip on their everyday shoes without hesitation, but your dark, cozy shoe is definitely a good place for critters to hide. Dr. Kate found out first hand this week why you might want to start checking all your shoes before putting them on.

This spider was found in Dr. Kate’s running shoes right out of her gym bag. This spider is VERY likely a female Black Widow spider (note the red hourglass on her belly). The black widow’s neurotoxic venom can be deadly if left untreated, although survival rate is quite high if treatment is sought.

Spiders and other insects are seeking shelter as the weather gets cold; so, remember to keep an eye out for spiders camping out in your shoes, even those that you wear regularly.

Dr. Kate has been making her way across Blacksburg to inform those of common injuries during sports and ways to prevent and care for them. Click on Dr.Kate’s Running 101 to review her powerpoint presentation.

Treating athletes with 5th metatarsal fractures:

Fractures occurring in the base area of the 5th metatarsal are a difficult burden for athletes.  The area lacks a healthy blood supply and a tendon attaches at its base. The tendon, if not immobilized in a cast of boot, will keep pulling on the fracture fragment. This repetitive pulling keeps the fracture from healing well. Conservative treatment for competitive athletes, and NOT the average joe, have been found through research to be inadequate.

This fracture can take close to 8 weeks to heal and has a higher rate of fracturing again, especially with early activities.  Surgical intervention, therefore is the way to go.  One recent podiatric journal stated that on average the athletes they operated on took a mean of 9 weeks to return to activities – some were even close to 14 weeks of recovery!  The only benefit of having the fracture surgically fixed is to hopefully heal the fracture sooner and prevent a recurring fracture. In a nut shell, it is a tough injury and a tough recovery regardless of if you do surgery or not!

More on common injuries to athletes here.

With snow arriving, we need to make sure we have the correct footwear on. This means waterproof boots that will keep your feet warm and dry when walking outside through the snow. However, any waterproof boot is not good enough. Your boots need to fit well to ensure that foot problems do not arise. To do this, have your foot measured by a knowledgable sales person or a professional. The best time of the day to be measured and try on any shoe is in the afternoon as your feet tend to swell later in the day. Feet should be measured every year, because the size can always change. Also a good tip to remember is that different brands of  boots may fit differently so when looking for boots, keep in mind that you should have a thumb length between the tip of your toes and the tip of the shoe. This will allow some room for your foot to expand when walking without being jammed as well as prevent blisters. When being measured, you may notice your feet are not the same size. ALWAYS go with the bigger size. One foot may have more room, but you do not want to create pain for the larger foot by cramming it into a smaller size.

Your new boot should be comfortable when trying it on in the store. Do not settle for a cute boot and say “I will break it in”. The best material for a boot is a natural material such as leather, which will keep your feet dry and comfortable during these winter months. Another good tip when looking for a boot is to make sure it has good traction; you do not want to be slipping when walking to your car or shoveling that drive way. The most common winter injuries are ankle sprains and fractures as a result to a slip, usually on ice, in addition to winter sport injuries.

One last tip: Check for spiders in the winter boots that you may have had packed away all summer.

Ever hear of OSHA? Occupational Safety and Health Administration. It’s a good abbreviation to remember if your feet hurt.  Especially when any and all chairs are removed at your work place based on “decreased productivity”.  Can your work place prove that you, occasionally sitting to DO WORK and not BREAKING from WORK, causes productivity to decrease?  I THINK NOT!  Show me the statistically significant research paper on this claim for your office then!?  If the chairs were there the first day of work, they should be available today for work. Just remember that…I am sure your feet will.

What is it?
Charcot foot is a condition caused by weakening of the bones in the foot usually seen in patients with neuropathy or nerve damage. The bones in the foot may fracture, the joints may collapse and the foot will change shape and become deformed with repetitive use. Charcot foot is a serious condition that can lead to deformity, disability and even amputation so it is important to take preventative measures and seek immediate care if signs or symptoms appear – especially those patients with diabetes or neuropathy.

Causes:
Charcot foot usually develops as a result of neuropathy because patients have decreased or no sensation for pain, temperature or trauma. These patients continue to walk on the injury without knowledge and make it worse. Patients with neuropathy are therefore at risk for developing Carcot foot.

Symptoms:

• Warmth to the touch (affected foot feels warmer than the other)
• Redness in the foot
• Swelling in the area
• Pain or soreness

Diagnosis:
To arrive at a diagnosis the podiatrist will discuss history, examine the foot, take x-rays or possibly order further imaging studies. X-rays will be taken periodically during treatment to assess progress.

Treatment:
Non-surgical treatment may consist of:

• Immobilization: The foot and ankle are fragile in the early stages of Charcot foot and must be stabilized in order to allow the weakened bones and joints heal properly. Complete non-weight bearing is necessary to prevent further collapse.
• Custom Shoes and Bracing: Bracing may be required if the deformity is significant. Shoes with special inserts may be used to help prevent recurrence of Charcot, development of ulcers as well as to enable the patient to return to daily activities.
• Activity Modification: A patient who develops Charcot in one foot is more likely to develop in in the other foot, so activity modification may be necessary to prevent injury and protect both feet.
• Surgery: Surgery maybe necessary in some cases, your podiatrist will determine the proper timing and procedure in each individual case.

Preventative Care:
You can play a vital role in preventing Charcot foot:

• Keep blood sugar levels under control to reduce the progression of nerve damage.
• See your podiatrist regularly for check ups.
• Check both feet every day
• Try to avoid injury such as bumping the foot or over exercising to strain the foot.
• Follow your podiatrist’s instructions for long-term treatment and prevention.

  
  
  Normal Lateral Foot X-Ray
  
  
  
   
  Charcot Foot X-Ray
  
  

No, turf toe is not the equivalent of a green thumb on your foot. It’s name represents  injury to the (metatarsophalangeal) MPJ joint located at the base of the toe – a sprain caused by overuse or hyperextension. Turf to can also be called a metatarsalphalangeal joint sprain. This type of injury is common among dancers and athletes, especially those who play on artificial turf (hense the name), but is not restricted to athletes. Anyone who hyperextends their big toe is capable of this type of injury.

Symptoms of turf toe are usually sudden as a result of injury (you may hear or feel a pop), but can also happen over time. Pain around the MPJ joint is a common symptom; sometimes swelling and stiffness can occur at this location as well. Turf toe is diagnosed with a thorough history, physical exam and x-rays.

Unfortunately for our athletic patients, treatment for turf toe often requires rest for at least a month. Bracing the MPJ joint isn’t easy, but limiting dorsiflexion (upward bending) of the toe can be done with taping the toe and wearing shoes with a rigid sole. A walking boot or cast may be used to immobilize the foot and toe. Physical therapy may be prescribed and NSAIDS can be used to decrease pain and inflammation. If left untreated, turf toe can become a chronic problem that is slow to heal, so don’t ignore it!

Although keyboard and mouse control from your feet may not sound like the most useful or easy to use device, for some, this could be a huge breakthrough.  This key pad for your feet makes it easier for people with disabilities, disease or amputations of the hands and arms to use a computer or even play video games! With this keypad for your feet, called the Soft Step KeyWorx multitouch foot controller, you can open and close applications including the internet, enter text, scroll and navigate with the cursor, bring a browser forward, control volume and zoom, and more. The 10 keys are fully customizable for functions that you use or need and it can be used with either a Mac or Windows.
Check out this video demonstration of the Soft Step KeyWorx foot controller. For more information and where to buy this device go to the company’s website.

Did you know that keeping your sugar in tight-control can help prevent foot pain or nerve damage? A national study involving 1,441 people with type 1 diabetes was published in the journal Diabetes Care, which showed patients who kept their sugar in tight control were 51 percent less likely to have nerve problems. Neuropathy, which causes foot numbness, plays a major role in the 80,000 foot and leg amputations performed every year on Americans with diabetes. About two-thirds of diabetic patients have this condition due to their diabetes. The study showed that after the eight years, those 1,441 people had no symptoms of neuropathy at the end of the trial.

” In all, participants who had begun with tight blood-sugar control and stuck with it were 51 percent less likely to report symptoms of neuropathy, and 43 percent less likely to show signs of it, than those who had started out with regular blood-sugar control and then gone to tight control. There were also differences between the two groups in the incidence of open sores requiring medical or surgical treatment, and in incidence of amputation.”

Even though this study was only done with type 1 diabetes, the most commonly seen diabetes today is type 2. The results did show implications for those with type 2 diabetes; “It suggests that good glucose control clearly protects patients over the long term” says senior author Dr. Eva Feldman.

Read more by going to this link